Chung Eric
Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia.
Department of Urology, Macquarie University Hospital, Sydney, Australia.
Transl Androl Urol. 2024 Aug 31;13(8):1657-1665. doi: 10.21037/tau-23-10. Epub 2024 Apr 26.
The current AMS 800 artificial urinary sphincter (AUS) device is designed to simulate the function of the biological urinary sphincter to prevent urinary flow through mucosal coaptation, compression, and pressure transmission. The challenges in designing the AMS 800 device involve not only the mechanical operation of the artificial sphincter device but also producing a device that is effective, safe, and durable for patients in the long term. The following article provides a narrative review regarding the evolution and development of the AMS 800 devices over the years and evaluates the advances in surgical techniques relating to AMS 800 implantation.
Available literature pertaining to the AMS 800 device was reviewed from the MEDLINE and EMBASE databases between 1 January 2000 to 31 December 2022. Emphasis is placed on key scientific publications including previous reviews and clinical guidelines relevant to AMS 800 device(s) and surgical techniques.
From the engineering point of view, the current AMS 800 device is ingenious and has stood the test of time. The basic design of this modern AUS consists of 3 separate components namely a pressure regulating balloon (PRB), an inflatable cuff, and a control pump. Continued innovations in device design and technology, coupled with refinements in surgical techniques over the past 5 decades have ensured that the AMS 800 device is and remains the standard of care in male stress urinary incontinence. While the long-term AMS 800 efficacy, safety, and durability are well documented, it is not without its limitations and complications. Mechanical and non-mechanical complications can occur especially in high-risk populations (such as in radiated patients) despite strict adherence to surgical principles and manufacturer's guidelines.
Continued innovations in device design, technology, and surgical techniques have ensured that the AMS 800 device is an effective and safe treatment for male stress urinary incontinence (SUI). Future directions in the treatment of male SUI likely reside in cellular regenerative therapy and nanotechnology to restore, replace, or simulate the damaged native urinary sphincter.
当前的AMS 800人工尿道括约肌（AUS）装置旨在模拟生物尿道括约肌的功能，通过黏膜贴合、压迫和压力传递来防止尿液流出。设计AMS 800装置面临的挑战不仅涉及人工括约肌装置的机械操作，还包括制造一种对患者长期有效、安全且耐用的装置。以下文章对多年来AMS 800装置的演变与发展进行了叙述性综述，并评估了与AMS 800植入相关的手术技术进展。
检索了MEDLINE和EMBASE数据库中2000年1月1日至2022年12月31日期间与AMS 800装置相关的可用文献。重点关注关键科学出版物，包括先前与AMS 800装置及手术技术相关的综述和临床指南。
从工程学角度来看，当前的AMS 800装置设计精巧且经受住了时间的考验。这种现代AUS的基本设计由3个独立部件组成，即压力调节球囊（PRB）、可膨胀袖带和控制泵。在过去50年中，装置设计和技术的持续创新，以及手术技术的改进，确保了AMS 800装置一直是男性压力性尿失禁的护理标准。虽然AMS 800的长期疗效、安全性和耐用性有充分记录，但它并非没有局限性和并发症。尽管严格遵循手术原则和制造商指南，但机械性和非机械性并发症仍可能发生，尤其是在高危人群（如接受过放疗的患者）中。
装置设计、技术和手术技术的持续创新确保了AMS 800装置是治疗男性压力性尿失禁（SUI）的一种有效且安全的方法。男性SUI治疗的未来方向可能在于细胞再生疗法和纳米技术，以恢复、替换或模拟受损的天然尿道括约肌。
